Provider Demographics
NPI:1447396213
Name:LEE, MAI (DC)
Entity Type:Individual
Prefix:DR
First Name:MAI
Middle Name:
Last Name:LEE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 ARCADE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55106-3246
Mailing Address - Country:US
Mailing Address - Phone:651-774-6616
Mailing Address - Fax:651-774-6686
Practice Address - Street 1:1008 ARCADE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-3246
Practice Address - Country:US
Practice Address - Phone:651-774-6616
Practice Address - Fax:651-774-6686
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4602111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor